PREVALENCE OF THE POLYCYSTIC-OVARY-SYNDROME IN UNSELECTED BLACK-AND-WHITE WOMEN OF THE SOUTHEASTERN UNITED-STATES - A PROSPECTIVE-STUDY

Estimates of the prevalence of the polycystic ovary syndrome (PCOS) in the general population have ranged from 2-20%. The vast majority of t hese reports have studied White populations in Europe, used limited de finitions of the disorder, and/or used bias populations, such as those seeking medical care. To estimate the prevalence of this disorder in the United States and address these limitations, we prospectively dete rmined the prevalence of PCOS in a reproductive-aged population of 369 consecutive women (174 White and 195 Black; aged 18-45 yr), examined at the time of their preemployment physical. Body measures were obtain ed, and body hair was quantified by a modified Ferriman-Gallwey (F-G) method. All exams were initially performed by 2 trained nurses, and an y subject with an F-G score above 3 was reexamined by a physician, the same for all patients. Of the 369 women, 277 (75.1%) also agreed to c omplete a questionnaire and have additional blood drawn. Subjects were studied regardless of current estrogen/progestin hormonal use (28.5%) . PCOS was defined as 1) oligoovulation, 2) clinical hyperandrogenism (i.e. hirsutism) and/or hyperandrogenemia, and 3) exclusion of other r elated disorders, such as hyperprolactinemia, thyroid abnormalities, a nd nonclassic adrenal hyperplasia. Hirsutism was defined by a F-G scor e of 6 or more, and hyperandrogenemia was defined as a total or free t estosterone, androstenedione, and/or dehydroepiandrosterone sulfate le vel above the 95th percentile of control values [i,e, all eumenorrheic women in the study, who had no hirsutism (F-G less than or equal to 5 ) or acne and were receiving no hormonal therapy; n = 98]. Considering all 369 women studied, White and Black women had similar mean ages (2 9.4 +/- 7.1 and 31.1 +/- 7.8 yr, respectively), although White women h ad a lesser body mass than Black women (24.9 +/- 6.1 vs. 29.2 +/- 8.1 kg/m(2), respectively; P < 0.001). Of these 7.6%, 4.6%, and 1.98 demon strated a F-G score of 6 or more, 8 or 10, respectively, and there was no significant racial difference, with hirsutism prevalences of 8.0%, 2.8%, and 1.6% in Whites, and 7.1%, 6.1%, and 2.1% in Blacks, respect ively. Of the 277 women consenting to a history and hormonal evaluatio n, 4.0% had PCOS as defined, 4.7% (6 of 129) of Whites and 3.4% (5 of 148) of Blacks. In conclusion, in our consecutive population of unsele cted women the prevalence of hirsutism varied from 2-8% depending on t he chosen cut-off F-G score, with no significant difference between Wh ite and Black women. Using an F-G score of 6 or more as indicative of hirsutism, 3.4% of Blacks and 4.7% of Whites had PCOS as defined. Thes e data suggest that PCOS may be one of most common reproductive endocr inological disorders of women.